Sports Medicine

Prolotherapy is an ideal first-line treatment for many athletic injuries. This regenerative medicine technique has gained tremendous momentum in the sports medicine arena, because athletes do not want to stop training for an event or give up on scholarships. Comprehensive Prolotherapy allows an athlete to continue exercising and maintain fitness, while promoting long term repair of the injured joint. Athletes looking for accelerated recovery options are ideal candidates for Prolotherapy.

How often do athletes need Prolotherapy?

Depending on how soon after an injury the athlete starts Prolotherapy, can help determine how many treatments are needed for long term pain relief. The average is 3 to 6 total treatments for most injuries. Many newer injuries require only one or two treatments for complete resolution, while an older, more complex injury may need 6 to 8. Prolotherapy treatments are generally given every 4 to 6 weeks, but can be moved closer to fast-track recovery.

Athletes can exercise between Prolotherapy treatments.

Motion and exercise are actually encouraged while getting Prolotherapy, as it brings blood flow and nutrients to the joint. This is unlike traditional “Rest” recommendations from the RICE protocol (Rest, Ice, Compression, Elevation), and unlike the weeks of immobilization after a surgery. Between treatments, athletes who receive Prolotherapy are encouraged to stay active. Specific recommendations for cross training and rehab exercises should be discussed with the Prolotherapy physician.

Often, a comprehensive Prolotherapy doctor will recommend adding Platelet Rich Plasma (PRP) to the treatment to bring growth factors directly to the injury. It has been found especially helpful in tissue which has a poor blood supply, including specific tendinopathies, meniscal tears, and labral tears of both the shoulder and hip. Meniscus and labrum tears leave their respective joints unstable, often causing clicking and popping upon movement. Continuing to exercise and stress an unstable joint quickly continues down the degenerative cascade to osteoarthritis. Removing the tissue, such as during a meniscectomy, exponentially shortens the timeline for the athlete to develop arthritis. Combining traditional dextrose Prolotherapy with Platelet Rich Plasma offers athletes with these conditions an alternative to surgery, and a chance to reverse the arthritic trend.

Prolotherapy = regenerative. Cortisone = degenerative.

The average athlete with a chronic injury has probably been offered, or had, at least one corticosteroid injection. While these injections may help dull pain temporarily, they are damaging to the joint, and the athlete will still be performing on an injured joint. The combination of which poses a great long term threat to the integrity of the joint, and setting the stage for surgery or joint replacement in the future. Remember, Prolotherapy “proliferates” new, healthy cells to repair the damage in the joint, addressing and eliminating the root cause of the pain.

Back and neck pain

Back and neck pain in athletes is common, often due to overuse or taking a hard hit in contact sports. Sports such as yoga and cycling can also aggravate pain in the neck and back. The pain can be chronic and dull, or cause spasms and shooting pains into the arms and down the legs. Sports medicine doctors are challenged with finding quick solutions which, ideally, do not cause further injury. Unfortunately, the options are not promising in traditional medicine—back braces, epidurals, non-steroidal anti-inflammatories (NSAIDs), and high velocity spinal adjustments become a crutch for many athletes with back and neck injuries. Often, these do not give long term pain relief, because they do not address the most common cause of back pain: ligament laxity, which allows for chronic subluxation and cervical instability. Strengthening the underlying cause of the pain with Prolotherapy can allow an athlete to return to sports quickly and safely.

Common diagnoses for which an athlete with back and neck pain would seek Prolotherapy include:

Bulging discs

Cervical instability and cracking

Degenerative disc disease

Headaches

Herniated discs

Muscle spasms

Overmanipulation syndrome

Radiculopathy

Sacroiliac instability and subluxation

Knee pain

Knee pain is one of the most common reasons athletes seek medical care. Traditional treatments for knee pain can include bracing, cortisone injections, exploratory surgery, and long periods of rest. Unfortunately, in most cases of chronic knee pain, relief is only temporary. This is because the origin of pain is not addressed, ligament instability. It is ligament instability which actually precedes the loss of cartilage in a knee. Treating the ligament instability with Prolotherapy encourages joint restoration and can eliminate the need for long term symptom management, making it an ideal non-surgical option for knee pain in athletes.

Common diagnoses for which an athlete with knee pain would seek Prolotherapy include:

Foot and ankle pain

Foot and ankle injuries can sideline a runner or walker in any sport. Common suspects are generally ruled out quickly by the athlete—poorly fitting shoes, for instance. The average athlete with foot pain will travel from podiatrist to podiatrist, eventually landing in an orthopedic surgeon’s office, only to have suffered ill-fitting orthotics, steroid injections, and potentially staring down multiple surgeries. Weakness in the ankle joint, as well as through the foot and Achilles tendon attachments needs to be addressed. Prolotherapy strengthens the attachments over the course of treatment, addressing the genesis of the pain.

Common diagnoses for which an athlete with foot and ankle pain would see Prolotherapy include:

Achilles tendinopathy

Ankle arthritis

Chronic ankle sprains and instability

Morton’s neuroma

Plantar fasciitis

Post-surgical foot and ankle pain

Shoulder pain

Shoulder injuries make advancement in sports impossible, especially in swimming or any throwing sport. An unstable shoulder joint can strip an athlete’s swing or stroke of its power, and produce excruciating pain. This pain is a signal that the body needs repair to the shoulder region. Often this involves damage to the glenoid labrum, the supraspinatus tendon, or the rotator cuff tendon, among other shoulder structures. As these structures degenerate further with every practice or game, the pain typically worsens over time. With Prolotherapy, the goal is to stop and reverse the degeneration. The Prolotherapy injections stimulate repair of the painful shoulder joint, and its numerous attachments. As it heals, a person can continue to be active, making it an ideal option for shoulder pain in athletes.

Common diagnoses for which an athlete with shoulder pain would seek Prolotherapy include:

Hip, pelvis, and hamstring pain

Hip, pelvis, and hamstring injuries often occur in kicking sports, such as soccer or mixed martial arts. Pain in this area can be quite debilitating to an athlete. When conservative treatments fail, including physical therapy, the athlete may push through the pain or take anti-inflammatory medications to dull the pain enough to continue playing. Training with a painful hip, or pain through the pelvic girdle will typically result in long term, more complicated pain. Athletes who want to stay on the playing field, but not neglect an injury, are seeking alternative treatments for hip pain. Correcting the ligament function via Prolotherapy treatment, provides natural healing options for athletes with chronic hip and pelvic pain.

Common diagnoses for which an athlete with shoulder pain would seek Prolotherapy include:

Groin strain

Hamstring tendinopathy

Ischial tuberosity pain

Pelvic instability or popping

Pubic symphysis dysfunction

Elbow, wrist, and hand pain

Elbow, wrist, and hand injuries frequently occur in racquet sports, as well as in gymnastics, and respond well to Prolotherapy. Athletes who complain of frequent flare-ups of pain through the arms, wrists, and fingers, are likely only putting a Band-Aid on the pain. Then, upon the next round of golf or tennis match, have to self-medicate with anti-inflammatories or use a brace to play. The body is, in fact, trying to send a signal that it is unstable enough to keep playing. To keep taking pain medications just to cover it up, is counterproductive in the long run. By triggering the healing cascade, Prolotherapy can eliminate chronic pain and sprains of the elbows, wrists, and hands.

Common diagnoses for which an athlete with elbow pain would seek Prolotherapy for include: